1 Solution-focused therapy: twenty years on · of paradox and the strategic wizardry of Milton Erickson’ (Guerin, 1976: 20). While this is a somewhat dated de ﬁnition, it is the

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1 Solution-focused therapy:twenty years on

The emergence of solution-focused therapy in the 1980s:context and antecedents

Solution-focused therapy (SFT) was developed in an American clinical familytherapy setting in the 1980s, a particular context and time when family ther-apists had some specific challenges to contend with. The initial target audi-ence for its dissemination was the community of American family therapists,peers of de Shazer, Berg, and their team in Milwaukee. Three factors thatboth provided a receptive context for the development of SFT and also acted asantecedents to its development are: (1) the field of family therapy itself; (2) theincreasingly convincing case for brief approaches; and (3) the existence of briefstrategic therapy.

The field of family therapy itself

A review of the evolution of family therapy up to the 1980s indicates adynamic and ever-changing expansion of ideas focused on a family orienta-tion. Cybernetics (the study of control and regulatory systems), family systemstheories, and Bateson’s work on communication were influential in shapingthe new therapy. Gregory Bateson, John Weakland, Jay Haley, Virginia Satir,and other members of the Mental Research Institute in California were signifi-cant early innovators in family therapy, as were Salvador Minuchin (associatedwith structural family therapy) and Monica McGoldrick and Betty Carter(associated with the changing family life cycle and developmental stage ther-apy) on the east coast of the USA. European theorists of note – includingprominent teams from the UK, Ireland, and Italy – also emerged duringthis time.

An ever-increasing range of approaches in the 1970s widened the popular-ity and influence of family therapy primarily through individual, charismatic,and gifted therapists who became international celebrities. These were the

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valued communication channels of the time, long before information tech-nology had such an impact on the dissemination of ideas and information. Asthe field expanded, attempts to classify different approaches met with varyingdegrees of success, with one author by the mid-1980s admitting defeat: ‘It issaid there are as many ways of practising family therapy as there are workers inthe field’ (Burnham, 1986: 62). By the late 1980s, not only was there a plethoraof family therapy models but also concern that claims for its effectivenesswere overstated.

By the early 1990s, family therapy was assailed by a wider range of criti-cisms. Feminist critiques, such as those of Hare-Mustin (1978, 1987) and Pilalisand Anderton (1986), identified a blindness to gender difference in systemstheory and the low status and lack of attention paid to traditional femaleroles of caretaking and nurturing as issues of concern. Consumer studies,such as that of Howe (1989), were indicating that: clients did not feel under-stood by family therapists on their own terms; sessions were dominated bytherapists who set the agenda; and clients felt powerless and disliked videotap-ing and live supervision. Howe came to the conclusion that systemic familytherapy was unable to understand the significance of individual personalexperience, banishing the subjectivity of the user and preventing a genuinedialogue taking place between the user and their therapists. In their searchingreview and critique of family therapy, Reimers and Treacher (1995) found that:first, (at that time) claims for most models were not supported by empiricalfindings (with the exception of behavioural and psycho-educational models);second, many of the major theorists of the time did not demonstrate anycommitment either to validating their results or exploring the service-user’ssubjective experience; and third, there were problems with theory develop-ment and dissemination. The family therapy movement itself was chargedwith being:

disproportionately shaped by the influence of charismatic leadersperforming (literally) as showmen at important conferences and work-shops . . . apparently highly effective interventions are demonstratedby skilful practitioners who are excellent showmen. Failures are typic-ally not shared and there is usually little attention paid to researchfindings. Many of the presenters of such workshops actually earntheir living from their presentations so there is often an in-built mar-keting factor which militates against presenters being objective abouttheir own successes and failures.

(Reimers and Treacher, 1995: 24–25)

The conclusion Reimers and Treacher reached was that if family therapywas to fulfil its potential as an ethical and effective practice, more atten-tion had to be paid to the user’s perspective and less to a fascination with

10 THE SOLUTION-FOCUSED HELPER

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versions of systems theory, which rendered the user (and individual subjectiveexperience) invisible.

The increasingly convincing case for brief approaches

An important debate in family therapy (and indeed individual therapy) at thetime also focused on the relative benefits and disadvantages of short-term ver-sus long-term approaches. This is a subject of enduring interest not only topractitioners but also to policy-makers and public service managers responsiblefor the ethical and efficient use of resources. In the early twentieth century,Freud and collaborators such as Sandor Ferenczi initially practised psycho-therapy in brief and concise forms (Budman, 2002). In the mid-1950s, familytherapists were using brief treatment approaches, although these were not for-malized into models for practice until the late 1970s (Erickson, 1954; Haley,1973). Long-term work was seen to be expensive, demanding for practitionersand clients, and risked creating problems of dependency. There were also fearsthat long-term therapy could become directionless. Motivation was thought tobe highest at the initial crisis point of seeking help or in the first few sessions.Research results indicated that clients not only preferred brief interventions butalso generally tended to stay in therapy for between six and ten sessions (Reidand Shyne, 1969; Garfield and Bergin, 1978; Koss, 1979). It was also shown thatthose receiving brief interventions (six to eight sessions) achieved significantlymore positive change than those receiving an open-ended service (Reid andEpstein, 1972), and that changes made in short-term treatments were at leastas durable as those in longer-term interventions (Reid and Shyne, 1969; Fisher,1984). As the issue of cost-effectiveness became more compelling, the case forfavouring brief therapies and interventions grew (Barker, 1995). The increasingfocus on short-term interventions has not been without its critics however.Some have linked the growth of short-term focused interventions to an increas-ing emphasis on ‘surface’ over ‘depth’ (Howe, 1996) in helping methods;others (Stevenson, 1998) have raised concerns about the appropriateness ofshort-term targeted interventions with particular problems such as chronicchild neglect. Some of Stevenson’s concerns mirror those of Howe regardingthe lack of attention paid to meaning and causal theories in the rush to be brief:

The need to find meaning in the behaviour of neglectful parents is aprerequisite for effective work with them . . . Why cannot a parentcontrol or protect their children? Why do some parents live in uttersqualor and discomfort?

(Stevenson, 1998: 113)

Advocates for SFT, as a therapy that initially not only carried but promotedthe label of a brief form of intervention at a time in the 1980s when such

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approaches were in particular vogue, probably contributed to the notion thatall problems could be solved in the short term and so played into the handsof North American health insurers and service providers who at the timeintroduced restrictions on lengths of treatment. The introduction of ‘ManagedCare’ by health insurers in the USA at the time was seen to be particularlydetrimental. Although the initial emphasis on brevity had these unintendedconsequences, it is important also to recognize that for de Shazer the centralpoint was that professionals should not overstay their welcome in clients’lives, and should seek to help clients make necessary changes as speedilyand as efficiently as possible. Nor was the emphasis on brief interventionsembraced by all SFT advocates. Lipchik (1994) specifically criticized this elem-ent of the early practice model. Although the central notion that formal help-ing interventions should be, wherever possible, brief, effective, and efficient,these critiques remind us of the risks of a rush to be brief, the heterogeneityof ‘problems’, and the complexity of processes of change.

The existence of brief strategic therapy

Brief strategic approaches are the true precursors to SFT. Strategic therapy hasbeen defined as a combination of ‘a communication systems approach, the useof paradox and the strategic wizardry of Milton Erickson’ (Guerin, 1976: 20).While this is a somewhat dated definition, it is the most useful for the purposeof comparison here. Erickson’s work as a psychiatrist and therapist in the1940s and 1950s was ‘uncommon’ for the time, especially when viewedagainst the prevailing psychodynamic orthodoxy, in particular his use ofparadoxical injunctions and the use of metaphor in communication (Haley,1973). The Mental Research Institute (MRI) founded by Don Jackson in PaloAlto, California in 1959, brought together some of the original members ofGregory Bateson’s communication project team, such as Haley and Weakland,and incorporated ideas from Erickson’s uncommon techniques to establishthe MRI Brief Therapy Project. Their approach was outlined in two major pub-lications in 1974: a book entitled Change: Principles of Problem Formation andProblem Resolution (Watzlawick et al., 1974) and a paper in the journal FamilyProcess, ‘Brief therapy: focused problem resolution’ (Weakland et al., 1974).Defining brief therapy as (i) focusing on observable behavioural interaction inthe present and (ii) involving deliberate interventions to alter the ongoingsystem, the MRI group claimed a new conceptualization of the nature of prob-lems as well as their resolution. Brief therapy in this mould was characterizedby the absence of any ‘elaborate theory of personality or dysfunction’ andrelied instead on simple diagnostic formulations that would allow therapists tointervene as briefly and effectively as possible (Cade and O’Hanlon, 1993: 5). Itwas based on the premise that the types of problems people need help withpersist only if they are maintained by ongoing behaviour by themselves and


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others (in other words, ‘stuck’ patterns of behaviour or thinking), and thatthe problematic behaviour or thinking is not in itself a symptom of a deepersystemic dysfunction thus obviating the need to engage in self-exploration orfocus intensively on the past. The role of the therapist becomes that of anactive agent of change (and more of this later) whose aim is to intervene ‘toalter poorly functioning patterns of interaction as powerfully, effectively andefficiently as possible’ (Weakland et al., 1974: 145). Cade and O’Hanlon (1993)describe brief therapy as concentrating on promoting change rather than pro-moting growth, understanding or insight; where the role adopted by the helperis one of agent of change; which uses the term interactional rather than sys-temic; and focuses on ‘observable phenomena, is pragmatic and related to thebelief that problems are produced and maintained 1. by the constructs throughwhich difficulties are viewed, and 2. by repetitive behavioral sequences (bothpersonal and interpersonal) surrounding them . . . (which can) . . . include theconstructs and inputs of therapists’ (Cade and O’Hanlon, 1993: 5).

In summary, the context of American family therapy at the time that SFTemerged from Milwaukee in the 1980s was one where established methodsof family therapy were considered by some to be over-technical and anti-humanistic, overly popularized by high-profile charismatic leaders in publicperformances, under-developed in terms of evidence of effectiveness, and lack-ing in service-users’ perspectives. Despite valid concerns about the growingdominance of brief methods of interventions (and what that indicated aboutbroader changes in social conditions where health insurers and service pro-viders were limiting budgets for psychological therapies), there has been anenduring interest in them to the point now when brief therapies are thetype most commonly offered (Macdonald, 2007). Brief therapy as it emergedfrom the MRI group offered a template for a short-term intervention with apragmatic focus on problem resolution. Strategic therapies had fallen into dis-repute primarily because of concerns about the ethics of some techniques,such as paradoxical injunctions (Carr, 1995). This, then, was the contextwithin which SFT found favour.

Given the range of criticisms that family therapy was attracting at thetime, the appeal of SFT is understandable: operating from principles thatemphasize the client as a person of resources, it questions the assumption thatthe therapist/helper knows best, redefining the role of the therapist/helper asfacilitator and collaborator rather than all-powerful expert.

The emergence of solution-focused therapy

Solution-focused therapy is attributed to Steve de Shazer, Insoo Kim Berg,and their colleagues at the Brief Family Therapy Center (BFTC) in Milwaukee,


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Wisconsin (de Shazer, 1985, 1988, 1991; de Shazer et al., 1986). The originalteam at BFTC also included Eve Lipchik, Elam Nunnally, Wallace Gingerich,and Michelle Weiner-Davis. That the development of the model was a col-laborative exercise centring primarily on the partnership of de Shazer and Berg(but with other team members contributing a significant role) is evident fromsubsequent publications and presentations. While this chapter will continueto refer to the model as ‘de Shazer’s’ (because he authored most of the seminalpublications in the 1980s and 1990s from the BFTC), it is in my view moreaccurate to view de Shazer and Berg as joint developers of SFT but with othersdeserving credit for their role as members of the original clinic team. The laterpublications by de Shazer and Berg prior to their deaths in September 2005 andJanuary 2007, respectively, reflect more accurately the central role Berg playedin the refinement of the model across a range of practice settings (Berg andKelly, 2000; Berg and Dolan, 2001; Berg and de Jong, 2002; Berg and Steiner,2003). As subsequent publications by Lipchik (2002), Weiner-Davis (O’Hanlonand Weiner-Davis, 2003), and other members of the original team makeclear, they too have a legitimate claim to the increasingly broad church ofsolution-focused approaches.

After years of experimentation on different pathways through the thera-peutic process, always focused on a pragmatic search for ‘what works’, andinformed by close observation and review of bona fide therapy sessions,de Shazer and Berg made their conceptual advance in the early to mid-1980s.Both have always acknowledged the influence of other theorists and model-builders, in particular Gregory Bateson, Milton Erickson, and John Weakland(de Shazer et al., 2007). De Shazer also saw his development of the solution-focused model as a progression of the MRI approach:

We have chosen a title similar to Weakland, Fisch, Watzlawick andBodin’s classic paper, ‘Brief Therapy: Focused Problem Resolution’to emphasize our view that there is a conceptual relationship and adevelopmental connection between the points of view expressed inthe two papers.

(de Shazer et al., 1986: 207)

In the early publications, the roots of the SFT approach in strategic ther-apy were obvious not only in de Shazer’s conceptualization of problems, thechange process, and an intervention model (de Shazer, 1985, 1988; de Shazeret al., 1986), but also in his adoption of many features of the MRI approach,including:

• reframing (defined as changing ‘the conceptual and/or emotional set-ting or viewpoint in relation to which a situation is experienced andto place it in another frame which fits the “facts” of the same situation


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equally or even better, and thereby changes its whole meaning’;Watzlawick et al., 1974: 95);

• the use of tasks; and• the depiction of different levels of commitment to change.

The connections between Erickson’s formulation of strategic therapy, thebridge of the MRI brief therapy model, and de Shazer’s starting point forSFT are clearly shown when mapped as in Box 1.1.

While incorporating these components, de Shazer also departed from theMRI model in several significant ways:

• the use of compliments and the active elicitation of exceptions andstrengths;

• the emphasis on the development of a cooperative relationship; and• the shift from task to process.

Solution-focused therapy, as initially developed, consisted of a formulaic,

Box 1.1 Conceptual linkages between Erickson and de Shazer

Erickson’s 12 ‘uncommontechniques’

De Shazer’s 7 correspondinginterventions

Encouraging resistance Resistance – the family’s unique way ofcooperating

Communicating in metaphor Constructing metaphors using client’sphraseology

Encouraging a relapse Prediction of setbacks/emphasis change asnon-linear

Emphasizing the positive Clients viewed as doing their best; use ofcompliments

Seeding ideas Possible solutions suggested as ‘clues’Amplifying a deviation Exceptions – elicit, amplify, reinforceAvoiding self-exploration Concrete goals and future focus/avoid

problem-focus

Amnesia and the control of informationAwakening and disengagementProviding a worse alternativeEncouraging a response by frustrating itThe use of space and position

Erickson’s uncommon strategies expanded from Haley (1973). Many also present inMRI work.


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staged practice model for a clinic-based session (de Shazer et al., 1986) ina deliberate and conscious replication of the 1974 MRI model. De Shazer’s1985 and 1988 books developed the theory behind the main concepts inthe model, while his two later books in 1991 and 1994 developed the philo-sophical foundation of his theories of therapy and in particular his reconcep-tualization of therapy as a language-game, as he was increasingly influencedby Wittgenstein’s work on the philosophy of language. The final posthumouspublication (de Shazer et al., 2007) provides a useful insight into their (deShazer and Berg) thinking some twenty years on. While they restate manyof the core concepts of the approach, they also highlight new aspects – forexample, the role of the therapist/helper is now acknowledged as being locatedwithin a hierarchical relationship, not one of equality with clients.

There follows a quick summary of SFT as originally developed beforewe consider its subsequent linkage with social constructionism andpostmodernism.

Core principles of solution-focused therapy

De Shazer et al. (1986: 208) describe the key to SFT as: ‘Utilising what clientsbring with them to help them meet their needs in such a way that they canmake satisfactory lives for themselves’. The main principles underlying theapproach are:

1 Problems develop and are maintained in the context of humaninteractions. Individuals possess ‘unique attributes, resources, limits,beliefs, values, experiences and sometimes difficulties, and they con-tinually learn and develop different ways of interacting with eachother’ (p. 208). Solutions lie in ‘changing interactions in the contextof the unique constraints of the situation’ (p. 208).

2 The aim is to get clients doing something different, ‘by changing theirinteractive behaviour and/or their interpretations of behaviour orsituations so that a solution (a resolution of their complaint) can beachieved’ (p. 208).

3 Clients are viewed as experts on their own lives. De Shazer subscribesto Erickson’s belief that individuals have a reservoir of wisdomlearned and forgotten but still available. The task of the practitioner isto facilitate the client in making contact with forgotten or unnoticedwisdom.

4 ‘Resistance’ is viewed not as a label to be affixed to particular clients(usually deemed to be uncooperative), but as ‘the client’s way ofletting us know how to help them’ (p. 209). The key to cooperationis ‘to connect the present to the future (ignoring the past, except for


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past successes) . . . point out to the client what we think they arealready doing that is useful and/or good for them, and then – oncethey know we are on their side – we can make suggestions for some-thing new that they might do which is, or at least might be, good forthem’ (p. 209).

5 The meanings attributed to particular behaviours are seen to be ofsignificance, especially in relation to the detrimental effects of label-ling. The meaning that any behaviour is given depends on perceptionand perspective. Reframing is therefore proposed as a way in which‘new and beneficial meaning(s) can be constructed for at least someaspect of the client’s complaint’ (p. 209).

6 Goals should be small and achievable, since only a small change ‘canlead to profound and far reaching differences in the behavior ofall persons involved’ (p. 209). The bigger the goal identified or thebigger the desired change, the more difficult it is to either establish acooperative relationship or to achieve success. De Shazer (1991) sub-sequently articulated more fully the qualities of well-formed goals(reproduced later in this chapter). One small change in one part ofan interactional system leads to changes in the system as a whole.Individual change can trigger interactional change.

7 Perhaps most controversially, de Shazer initially insisted that solution-construction did not require a detailed knowledge of the problempattern: ‘How will we know when the problem is solved? . . . Detailsof the client’s complaints and an explanation of how the troubleis maintained can be useful for the therapist and client for buildingrapport and for constructing interventions. But for an interventionmessage to successfully fit, it is not necessary to have detailed descrip-tions of the complaint. It is not even necessary to construct a rigo-rous explanation of how the trouble is maintained’ (p. 209). Thisstance was unsustainable in practice and the SFT model clearlyincorporates a stage of quite detailed problem exploration prior toaction.

The 1986 clinical model of de Shazer et al.

It is worth noting the different stages in the helping process as initiallyformulated:

1 Pre-session change. On the basis that asking for help in itself is a newbehaviour (and that this change in itself can lead spontaneously toother changes), and one that the self-referring client can take fullcredit for, the client is given a task when making an appointment:


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‘Between now and the time when we meet, can you look out and noteany changes or differences (in the problem)?’

2 Problem-free talk (building rapport and locating strengths). In thisphase of the interview, the worker is encouraged to connect with theperson, find out a bit more about them beyond the parameters ofthe problems, and note what the client does well, what adversity theyhave overcome, and what strengths they display. The practitionerstarts to listen with a constructive ear (Lipchik, 1991) for the strengthsthat the client brings and ways they have already developed to dealwith adversity.

3 Statement of the problem pattern. Although de Shazer maintained thatfor an intervention message to fit successfully it is not necessary tohave a detailed picture of the problem, in practice some explorationof the problem pattern almost always takes place. The point de Shazerwas emphasizing is that detailed explanations of problem patternsmay not necessarily lead to solutions, as problem patterns and solu-tion patterns may be dissimilar. An experimental trial by Macdonald(2007) and his team in Scotland in omitting to ask for any informa-tion about ‘the problem’ resulted in negative feedback from clientsand this approach was abandoned.

4 Exploration of solution patterns. This takes place by eliciting and ampli-fying exceptions to the complaint and successful attempts to dimin-ish its effects, and by eliciting and amplifying successful behaviourand thoughts in other areas of life. The focus is on interactional pro-cesses, which either maintain a problem pattern or interrupt it. Thesearch for exceptions (through the use of such questions as, ‘tell meabout the times when it doesn’t happen/when it’s less bad/when yousay “no” ’) is seen to be an intervention in itself, as it implicitly letsthe client know that there are times when they are being effective,and therefore reframes them as competent rather than powerless inthe face of the problem. It can therefore provide some hope for clientsthat problems can be solved or alleviated or that they can be com-petent and resilient in the face of problems. The importance of lan-guage in the careful framing of questions is implicit in this approach.Exceptions are amplified by the worker as they will help ‘to createthe expectation that a future is possible which does not include theproblem’ (de Shazer et al., 1986: 210).

5 Goal-setting is emphasized as crucial, so that both worker and clientwill know when it is time to terminate contact. This phase is alsoimportant because the essence of SFT is to convey to the client thatchange is not only possible but inevitable. Goal-setting also providesa clear focus for therapy, and facilitates evaluation of progress andoutcome. Two techniques most associated with SFT – The Miracle


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Question and Scaling Questions – are actively used to determine pro-gress towards well-articulated goals. De Shazer later elaborated onthe characteristics of well-formed goals as outlined in Box 1.2.

6 The small steps of change. Once specific, observable goals are co-constructed along the lines suggested above, small steps of change canbe mapped out. De Shazer sees this as an intervention in itself, in thatthe more time spent in a session on ‘change talk’, with the focus beingon the absence of the complaint and what will replace it, the more itcreates the expectation that change is not only possible but inevitable.

7 The ‘break’ and the message/homework. A planned interruption in thesession when the practitioner devises the message to be delivered tothe client at the end of the session. What is emphasized is the import-ance of the ‘fit’ (i.e. the relevance) of the message. The task for thepractitioner is to devise a message that shows a client that their situ-ation is understood and that acknowledges them (compliments) whilealso flagging up possible solutions that the client may find acceptable(clues). Compliments are designed to establish a ‘yes set’ (Erickson andRossi, 1979) of agreement from the client so that he or she would bemore receptive to the clues or directions put forward. However, posi-tive feedback has since been built into the fabric of the session bymany practitioners as an important challenge to the view of self aspowerless or at fault. De Shazer initially developed a series of formu-laic tasks to be given in homework but these are not too commonlyused in practice now.

This, then, is the essence of the SFT model as it was initially developed in 1986and, as already noted, disseminated in an influential journal (Family Process) topeers in family therapy settings. The emphasis was on a minimalist prescription

Box 1.2 Characteristics of well-formed goals (de Shazer, 1991: 112)

‘Workable goals tend to have the following general characteristics:

1 Small rather than large;2 salient to clients;3 described in specific, concrete, behavioural terms;4 achievable within the practical contexts of clients’ lives;5 perceived by the clients as involving their “hard work”;6 described as the start of something and not as the end of something;7 described as involving new behaviours rather than the absence or cessation

of existing behaviours.’


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for therapy with the development of a single session model. Only as SFTbecame known and popularized outside of clinical therapy settings did itsadaptability and versatility become more evident and the focus move beyondthe initial session. Initially adopted by family therapists, the model began toattract a more general interest from those in the helping professions from theend of the 1980s onwards. It has since been modified for work in varioussettings, with diverse client groups and types of problems, across the globe –from Asia to continental Europe, North America to the Antipodes. The lastpublished work outlining the core approach from de Shazer and Berg (de Shazeret al., 2007) reiterates the major interventions of the approach and illustrateshow they have retained a consistency since 1986. They are outlined in Box 1.3later in this chapter.

Is solution-focused therapy a strategic form of therapy?

Both in 1986 and in subsequent publications, de Shazer explicitly conceptual-ized his SFT model as a derivative of but different from the Mental ResearchInstitute (MRI) model of brief strategic therapy. That SFT is both strategic andcomplementary to the MRI model was a view expressed by members of the MRIteam: ‘At a specific level, I do not think the use of the term “strategy” necessar-ily implies a contest between therapist and client; indeed I would propose thatde Shazer carries on his therapeutic conversations strategically’ (Weakland,1991: viii). Some analysts agree that the SFT and MRI models are more similarthan different (Cade and O’Hanlon, 1993; Shoham et al., 1995) and that theSFT model is a strategic approach (Weakland, 1991; Shoham et al., 1995) or atleast consistent with strategic approaches (Gale and Long, 1996): ‘We focusprimarily on attempted solutions that do not work and maintain the problem;de Shazer and his followers, in our view, have the inverse emphasis. The twoare complementary’ (Weakland and Fisch, 1992: 317).

While solution-focused techniques may be used strategically, the innov-ations de Shazer introduced are in my view sufficient to locate it outside therealm of brief strategic approaches. These include:

1 The emphasis given to the concept of future-focused ‘solutions’ asopposed to resolution of the problem.

2 The reformulation of the therapist–client relationship as a co-constructivist and collaborative relationship, albeit with the morerecent caveat that solution-focused helpers ‘accept that there is ahierarchy in the therapeutic arrangement, but this hierarchy tendsto be more egalitarian and democratic than authoritarian’ (de Shazeret al., 2007: 3–4).

3 The focus on process rather than interventions and the emphasis


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placed on alternative possibilities and meanings that the therapistoffers the client through the construction of solution-focused conver-sations. By 1985 de Shazer saw therapeutic change as ‘an interactiveprocess involving both client and therapist’ (de Shazer, 1985: 65).Despite this, the approach does make use of particular techniques,mainly through a particular form of questioning.

4 The view of clients as essentially cooperative and as experts on theirown lives. From his earliest writings, de Shazer was interested in howthe most effective relationship could be developed between therapistand client and he began to note the differences in levels of cooperationthat were elicited by various strategies, such as the use of compliments.In his 1982 model, the contact with families began with what wastermed the ‘prelude’, where the therapist tries ‘to build a non-threatening relationship with the whole family and to learn some-thing about how the whole family sees the world’ (de Shazer, 1982: 27).

5 The abandonment of the need for a team approach. By 1985 de Shazerviewed the team as dispensable: ‘A team is not necessary for workingthis way’ (de Shazer, 1985: 19).

6 The rejection of task-setting as a central feature of therapy: ‘Acceptingnon-performance as a message about the client’s way of doing thingsallowed us to develop a cooperating relationship with clients whichmight not include task assignments. This was a shock to us becausewe had assumed that tasks were almost always necessary to achievebehavioural change’ (de Shazer, 1985: 21).

7 The emphasis on meaning and on the client’s subjective experience,beliefs, and values.

8 The importance of language, particularly the craft of constructing use-ful questions and utilizing the client’s own terminology in describingboth problem and preferred futures.

Specific techniques, such as the Miracle Question, the identificationof exceptions, and the use of scaling are arguably strategic in origin. In itsinitial conceptualization, the SFT model was highly prescriptive in its six-stage formula. Despite this, de Shazer can be said to have fundamentallyaltered the balance of power in the therapeutic relationship away from a stra-tegic stance by suggesting that therapists should start from a viewpoint ofseeing the client rather than the therapist as holding the key to the solu-tion. The role of the therapist in the SFT model became one of a facilitatorwho helps the client ‘discover’ forgotten wisdom and who does so through afirm focus on the future and the concept of goal-setting through the detaileddescription of a preferred reality, an element of the approach not previouslycentre-stage in therapeutic endeavours and still very distinctive in solution-focused helping.


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One answer to the question of whether SFT is strategic or not hasto be: ‘it depends’. And it depends on how SFT is interpreted and practisedby individual practitioners. In the hands of one it could be highly strategic,whereas in the hands of another not at all strategic. It is in the practisingof SFT that its true shape emerges, and that is conditional on qualitiesrelated to the practitioner as much as to the model itself; related to waysof thinking as much as ways of being. The issue of whether SFT is a strate-gic form of therapy might have continued to be debated if there had notbeen a wider paradigm shift (Kuhn, 1970) that created a change in thinkingabout how therapeutic endeavours work. By the 1990s, there was a newgrouping of social constructionist strengths-based models of practice, influ-enced by advances in developmental psychopathology, in particular theconstruct of resilience (Rutter, 1987, 1990; Luthar, 2000), the development ofthe strengths perspective in social work (Saleebey, 1992, 1997, 2001), theemergence of concepts of learned optimism and hope in psychology(Seligman, 1991; Snyder and Lopez, 2002), as well as the less helpful general-ization of a positive psychology movement (of which more later). Here SFTfound a new home.

Constructivism, postmodernism, andsocial constructionism

That SFT is of a new generation of social constructionist models is now gener-ally accepted. The interrelated ideas of social constructionism, constructi-vism, and postmodernism deserve some consideration with respect to theirinfluence on the field of therapy.

Social constructionism views ‘ideas, concepts and memories arising fromsocial interchange and mediated through language’ (Hoffman, 1990: 8), andas applied to therapy draws on the work of authors such as Kenneth Gergenand Michael Foucault. Wetchler (1996) proposed that four approaches, oneof which is SFT, fit this category, being ‘based on the concept that reality isan intersubjective phenomenon, constructed in conversation among people’(p. 129), identifiable by their adherence to four principles:

1 That reality is constructed in conversation, and that what we perceiveas ‘real’ is often due to dominant beliefs within ourselves and societyas we view the world through the lens of a succession of stories –personal and gendered but also influenced by community, class,and culture. As the concept of the ‘self’ is itself socially constructed,therapists do not have any special insights into individual or familylife but are instead participants in constructing a reality with theirclients.


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2 The systems metaphor for describing families is rejected. The ability oftherapists to objectively ‘diagnose’ families is challenged and so thesystems metaphor that encourages therapists to take an objectivestance is also rejected: ‘The concept of systems originally was used as ametaphor for describing families. Over time therapists began to viewfamilies as actually possessing those concepts’ (Wetchler, 1996: 131).

3 Therapist expertise holds no more prominence than client expertise. Draw-ing on work by Foucault, narrative therapists such as Michael Whitehighlighted the issue of how psychological knowledge and diagnosisoften reproduce dominant cultural values that serve to marginalizethe wisdom of those who are socially excluded and viewed as out-siders. By reframing the therapeutic encounter as one to which eachparticipant brings his or her own expertise, therapy is seen to becomemore ethically and morally sound: ‘By placing therapist knowledgeabove client knowledge, we not only further objectify and demean ourclients, but we also close the door to new and possibly unique ways ofviewing and solving client problems’ (Wetchler, 1996: 131–132).

4 Therapy is co-constructed between therapist and client. A balancing oftherapist knowledge with client knowledge leads to therapy becomingless hierarchical: ‘The role of the therapist becomes one of openingdoors for clients to explore new meanings in their lives. This meansengaging them in a slightly different conversation than the ones theyusually have around the problem’ (Wetchler, 1996: 132). Through thisnew dialogue, clients develop different ways of viewing their situation,and hence new ways of overcoming their difficulties.

As we shall explore further in Chapter 3 and the subsequent chapters on spe-cific practice settings, this assertion has to be tempered with recognition of therole and responsibilities of workers in different contexts.

Constructivist ideas were introduced into the brief strategic field primarilythrough Watzlawick’s (1984, 1990) work, followed by specific features infamily therapy journals in the later 1980s (Efran et al., 1988; Leupnitz, 1988).Constructivism has been defined as

an epistemological paradigm that has its roots in the writings of theGreek Skeptics . . . Constructivists view knowledge as actively con-structed by the individual, and although not denying an ontologicalreality, ‘deny’ the human experience the possibility of acquiring a‘true representation’ of reality.

(Gale and Long, 1996: 13)

‘The Inverted Reality’ (Watzlawick, 1984) drew together contributionsfrom a number of constructivist philosophers, of whom the radical construct-


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ivist, Von Glaserfeld, appears to have had most impact on both the MRI andthe Milwaukee team (de Shazer, 1988, 1991). These ideas were introduced intothe wider field of family therapy through the work of the Milan associates,especially Boscolo and Cecchin (Boscolo et al., 1987), and informed by theconstructivist school of Maturana and Varela (1987). Constructivism has beenviewed as most useful in its scepticism about the concept of truth: ‘Whenfamilies, or families and professionals, are engaged in battles over “truth”, aconstructivist frame that incorporates many different truths is invaluable’(Burck and Daniel, 1995: 26). Taken in isolation, constructivism can be blindto potential ethical and moral issues in relation to what is observed; and if itleads to a privileging of subjective reality, risks minimizing or ignoring issuesof oppression or abuses of power within and outside the therapeutic process.

Constructivist ideas brought about three important shifts in systemicthinking: the emphasis given to the functioning of the individual within thegroup and not exclusively to the collective phenomena of the system; greaterattention was paid to the meaning that one person has for another and thecognitive, emotional, and relationship factors that bind them together; andthe recognition that the presence of an observer changes the context of theobservations and therefore modifies the nature of the information gathered(Reder et al., 1993: 26). Constructionism, on the other hand, ‘based on theconcept that reality is an intersubjective phenomenon, constructed in con-versation among people’ (Piercy et al., 1996: 129), is more grounded in aphilosophy of community and relatedness.

Another important theoretical influence on de Shazer, which heincorporated more fully in his later publications, was postmodern philosophy.This had a broad impact on family therapy in its ability to provide ‘a frame-work within which to address differences and challenge polarities . . . whilepostmodernist ideas seem to reflect well the experiences of fragmentationand saturation that many individuals live in the modern world’ (Burck andDaniel, 1995: 29–30). Postmodernism could be problematic if it was inter-preted as according all narratives equal status, and ignoring context: ‘i.e. oursociety, which neither confers equal validity and status on all views, nor pro-vides the resources for all views to become established in practice’ (Burck andDaniel, 1995: 30). Solution-focused therapy is frequently categorized as one ofthree postmodern therapies (along with narrative therapy and collaborativelanguage therapies) distinguishable by an attempt to minimize an authoritar-ian stance in favour of a more collaborative approach. Subsequently, inte-grated models drawing on different postmodern approaches have beendeveloped, particularly in social work. Parton and O’Byrne (2000) outline asocial constructionist framework for social work practice that incorporatesboth solution-focused and narrative concepts and techniques. Their con-structive approach ‘emphasises process, plurality of both knowledge andvoice, possibility and the relational quality of knowledge . . . An ability to


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work with ambiguity and uncertainty both in terms of process and outcomesis key’ (Parton and O’Byrne, 2000: 184).

De Shazer can be said to have taken a postmodern stance on helping whenhe asserted that problems exist when clients acknowledge that there is a prob-lem to be addressed; and problems are resolved when clients’ evaluations indi-cate that this is the case. This stance created some formidable distance betweende Shazer and the evidence-based practice community, who distrust clientfeedback and evaluation as a sole source of knowledge.

Since the 1990s, the social constructionist paradigm has become morerather than less influential (McNamee and Gergen, 1992; Carr, 1995; Witkinand Saleebey, 2007). The effect it has had on brief therapists, some of whomstarted off using pure strategic models, is described thus:

We are now less certain, less audaciously tactical, less wedded to over-simplistic models, and far less impressed with our own cleverness. Wehave become more concerned with the resourcefulness of our clientsand with avoiding approaches that disempower, either overtly or cov-ertly. We have become more concerned with the development of acooperative approach.

(Cade and O’Hanlon, 1993: xii)

Although the metaphor of a conversation may now be frequently used todenote therapeutic encounters, to signal the changes towards a more equalrelationship between client and practitioner, and to indicate that both havecontributions to make, there is a limit to how far the metaphor can be taken ifthe practitioner is also to fulfil his or her professional and ethical obligation tooffer some expertise in how problems may be solved or solutions constructed.This point has now been acknowledged quite explicitly by de Shazer in asignificant shift:

SFBT therapists accept that there is a hierarchy in the therapeutic arrange-ment, but this hierarchy tends to be more egalitarian and democraticthan authoritarian . . . The therapist’s role is viewed as trying toexpand rather than limit options . . . SFBT therapists lead the session,but they do so in a gentle way, leading from one step behind.

(de Shazer et al., 2007: 3–4, my emphasis)

In accepting that therapists use influence to help people change and use par-ticular interventions to help them to do so, brief therapists implicitly restrictthe extent to which the metaphor of ‘conversation’ can be used to depict thetherapeutic encounter. The issue of how influence is used (and experienced) inwork with vulnerable people is as much a preoccupation for frontline workersin health and social care settings as it is for therapists explicitly designated


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to carry out psychological change-work. The development of anti-oppressiveand anti-discriminatory frameworks for practice in health and social care(Dominelli, 1988; Thompson, 1993, 1998, 2003) evolved from a concern abouthow workers sometimes use their power in an oppressive manner. In consider-ing the adaptations to the approach required for ethical practice beyond theclinic walls, such concerns will need not only to be recognized but will beaddressed in Part Two.

Solution-focused therapy: a moving target

Solution-focused therapy is acknowledged by many as being one approachthat has been adopted and applied in tremendously diverse ways, so that: ‘Anydescription of solution-focused therapy by outsiders will be, at best, a partialsnapshot of a moving target’ (Shoham et al., 1995: 151–152). This theme wasnot only accepted by de Shazer but elaborated upon:

We believe that it is useful to think about solution-focused therapy asa rumor. It is a series of stories that circulate within and throughtherapist communities. The stories are versions of the solution-focusedrumor . . . Our goal is not to offer the final, definitive and only credible storyabout solution-focused therapy. We recognize that rumors belong towhole communities. No particular story-teller ‘owns’ a rumor.

(Miller and de Shazer, 1998: 368, my emphasis)

That SFT continues to evolve is evident from the post-1986 publications ofde Shazer and Berg and others. A more fitting description for this ‘movingtarget’ may be as a minimalist formula that is underpinned by a number ofprinciples developed by other skilled therapists and which uses some simplestrategic interventions, but does so within a social constructionist perspectiveand with a strong dose of hopefulness at its core. That it is indeed a hybrid ismore proudly acknowledged by its originators now as they emphasize itsinductive and practice-based origins: ‘SFBT is not theory based but was prag-matically developed. One can clearly see the roots of SFBT in the early work ofthe Mental Research Institute in Palo Alto and of Milton H. Erickson; inWittgensteinian philosophy; and in Buddist thought’ (de Shazer et al., 2007: 1).

Also of relevance is the increasing emphasis placed in recent years on theprecise construction of questions and communication patterns. Payne (1997)places SFT in the category of practice models based on social communicationtheory. Kim and Franklin describe it as using

carefully posed questions that purposefully use communication toolsfrom communication science that change perception through co-


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constructive language, combined with collaborative goal setting, andthe use of solution-building techniques that occur between therapistand client . . . These carefully constructed communication processes arebelieved to be key components to helping client’s change. Solutions emergein perceptions and interactions between people and problems arenot to be solved solely by the therapist but rather solutions areco-constructed with the client(s).

(Kim and Franklin, 2009: 464, my emphasis)

As the model remains dynamic, it is more accurate to refer to the ‘family’of solution-focused approaches, which are themselves increasingly seen tobelong to a larger grouping (or ‘community’) of collaborative, language-basedapproaches. These are part of a generation of approaches to change-work basedon the epistemology of social constructionism and premised on the philo-sophical position that the therapist is not an omniscient expert but a facilitatorto the client seeking change.

While de Shazer launched his model in 1986 as a complete ‘prescription’for therapy, this status is debatable. Modifications made since then both by theoriginators and those who have applied it in various settings suggest that most

Box 1.3 Therapeutic principles (de Shazer et al., 2007)

1 Positive, collegial, solution-focused stance – positive, respectful, and hopeful2 A search for previous solutions3 Questions versus directives or interpretations4 Present and future focused questions versus past-oriented focus5 Compliments6 Gentle nudging to do more of what is working

‘The therapist’s role is viewed as trying to expand rather than limit options’ (p. 4).

Underlying beliefs1 The future is both created and negotiable: ‘With strong social constructionist

support, this tenet suggests that the future is a hopeful place, where peopleare the architects of their own destiny’ (p. 3).

2 No problems happen all of the time – there are always exceptions to beutilized, and the three main principles are: ‘If it ain’t broke, don’t fix it’; ‘If it’snot working, do something different’; and ‘If it works, do more of it’.

3 The language of solution development is different from that needed todescribe a problem: ‘The language of solutions is usually more positive,hopeful and future-focused, and suggests the transience of problems’ (p. 3).


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commonly it is used as an approach consisting of three elements – a beliefsystem, a set of principles, and an array of techniques – which are versatile andflexible and have proven adaptable across a range of problems and clientgroups and capable of being integrated with other approaches such as psycho-educational and cognitive-behavioural programmes.

Examples of the range of the approach include: residential child carein Australia (Durrant, 1993), groupwork with paediatric nurses in the UK(Goldberg and Szyndler, 1994), social work in child psychiatry in Ireland andthe UK (Wheeler, 1995; Sharry, 1996), mature social work students in the USA(Baker and Steiner, 1995), adolescent and adult substance abusers (Berg andGallagher, 1991; Berg and Miller, 1992b, 1995), Home Based Services for chil-dren and families (Berg, 1994), child psychiatry in Finland (Furman and Ahola,1992), community care social work in Ireland (Walsh, 1995, 1997), genericsocial work practice in Finland and the USA (Sundman, 1997; Maple, 1998),counselling practice in the USA (Littrell, 1998), fostering social work (Houston,2000), groupwork in Ireland (Sharry, 2001), child protection in Australia(Turnell and Edwards, 1999), child protection in the USA (Berg and Kelly,2000; de Jong and Berg, 2001; Antle et al., 2009), and social work practiceteaching in the UK (Bucknell, 2000). There are also texts that act as instructionmanuals for the development of solution-focused skills (e.g. de Jong and Berg,2008). This list is not exhaustive – and is supplemented by more detailedaccounts of the literature relating to specific practice contexts in Chapters 4–8– but it does demonstrate the extent of its appeal. Against this a range ofconcerns and criticisms has been voiced about the approach.

Critiques of solution-focused and brief methods

Some authors have taken issue with brief methods of treatment, otherswith cognitive approaches, and others with SFT itself. The more general cri-tiques will be explored first and followed by those specifically concernedwith SFT.

General concerns

Some British social work theorists deplore the rise of brief, focused methods ofintervention linking them to the rise of a radical liberal perspective: ‘Clientsarrive, in effect, without a history; their past is no longer of interest. It is theirpresent and future performance which matters’ (Howe, 1996: 88–89). Howebelieves that little attention is then paid to the construction and understandingof the client’s narrative:

Work is short-term, time-limited and ‘brief’ . . . There is no


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accumulated wisdom because there are no psychological or socio-logical theoretical frameworks in which to order and store it. Eachnew encounter simply triggers a fresh set of transactions, negotiationsand agreements.

(Howe, 1996: 90–91)

Howe maintains that this preoccupation with ‘surface’ rather than ‘depth’ pre-vents workers from understanding and appreciating the non-rational anddistressed behaviours of people under stress and that this inhibits their abilityto respond appropriately. Like Stevenson (1998), his concern is for those prob-lems and client situations that he believes are not amenable to minimalistinterventions. Taken in isolation, the original article by de Shazer et al. (1986)that launched SFT might give the impression that it uses the concept of ‘solu-tions’ to trick clients into thinking differently about their problems withoutany sensitivity or consideration for their subjective experience, and is narrowlyfocused on minimalist outcomes as Howe worries. If this were how it was prac-tised, it would raise major issues. The notion of persuading people that thingsare not as bad as they think clearly has to be tempered by an understanding ofboth the salient factors in people’s lives and of the need to express and processnegative and strong emotions. Of relevance here also is the critique of ‘positivethinking’ recently issued by Ehrenreich (2010). In her book, entitled Smile orDie: How Positive Thinking Fooled America and the World, she asserts that theassumption underlying positive thinking is that you only need to think athing or desire it to make it happen. She describes this practice as immoral, as itdupes people into thinking that they have control over aspects of their liveswhen they are in fact powerless. She relates this to the existing practice in theUSA of hiring motivational speakers to ‘counsel’ people being made redundantthat this catastrophe in their lives is in fact a golden opportunity, as so persua-sively conveyed by George Clooney as Ryan Bingham in the film Up in the Air.

As outlined earlier, many SFT practitioners emphasize the quality of therelationship forged between worker and client, and focus on process. Lipchik(1994) notes that the most obvious clinical error of all when using SFT is to‘focus on the technique and neglect the actual flesh-and-blood client sittingwith them . . . in general, the choice of techniques should be driven by how aparticular technique will serve and fit the client, not the therapist’ (pp. 37–38).Subsequent research on micro-communication (Beyebach and Carranza, 1997;Tomori and Bavelas, 2007) confirms the importance of following the client’slead in establishing an active engagement.

Research studies outlined in more detail in Chapter 3 indicate that SFT ingeneral is not normally used in a formulaic manner but has been most oftenthoughtfully combined with other approaches, and sometimes ‘re-invented’to meet the needs of specific clients or client groups. In Chapter 3, the extentto which practitioners drawing on the SFT approach exercise sensitivity and


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judgement in deciding when and how to use the approach will becomemore evident.

Political concerns

Objections to brief models of therapy have also been made on politicalgrounds based on the legitimate fear that policy-makers and budget-holdersultimately restrict choice and therapists’ professional autonomy by imposingrestrictions on the length and type of treatment. The introduction of ‘Man-aged Care’ in the USA and the curtailment on length of treatment funded byprivate insurance companies in Ireland and the UK illustrate that these fearsare justified. The issue centres not on dismissing the real benefits that briefmethods can offer but on promoting a deeper analysis of the complex natureof many problems, which acknowledges that short-term active change-work isnot always possible or appropriate. Again, although not obviously explicated,the SFT model does caution against presuming that all clients are ready (orable) to work towards change – de Shazer (following on from the MRI team)emphasized the importance of assessing whether a client was a ‘customer’ forchange or in another category. If the latter, other activities are needed tomotivate people towards more active problem-solving.

‘Grand claims’ concerns

Concern has been expressed about the indiscriminate acceptance of theSFT model by some social workers and social agencies, ‘in spite of the dearthof empirical evidence for its claims to provide clients with more rapid andmore enduring change than other treatment models’ (Stalker et al., 1999: 468).These objections have been echoed in the addictions field about SFT advocates(Miller and Berg, 1995) promoting ‘The Miracle Method’ as a radically newapproach to problem drinking. This claim is viewed as excessive given that(at that time)

not a single scientific evaluation has yet been published to supportthe ‘solution-focused’ counselling method that it described . . . [and]Desperate and vulnerable people deserve, and have a right to expect, ahigher standard of professional responsibility and accountability.

(Miller, 2000: 1765)

Stalker’s and Miller’s objections to the approach stem from the exaggeratedclaims of some SFT proponents. That both critiques emanate from NorthAmerica may reflect the lucrative and competitive nature of the therapybusiness there, but as British-based Edwards also notes:


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People in that sort of situation [with addiction problems] are, however,immensely vulnerable to the blandishments which may be offeredby any treatment approach which is marketed with large claims forefficacy and carries a public relations message which connives withexpectations of a magic cure.

(Edwards, 2000: 1749)

Clearly, there are issues involved in exaggerated claims: claiming anything as a‘miracle method’ is unethical.

‘Insensitivity’ concerns

Fook critiqued the growing development of strengths perspectives through-out the 1990s, which she maintains do not take account of the differingrealities, vulnerabilities, and challenges that individuals experience over theirlifetimes:

‘Progressive’ models of practice assume an ideal of ‘strength’ towardswhich the healthy personality works. Such views, however, do nottake into account the changing contexts and historical times whichall people experience in the course of a lifetime. In this sense, practicemodels may be far out of touch with the experiences of service users.

(Fook, 2000: 65)

The point she makes is that there is more complexity in human suffering thanthat allowed for in over-simplistic notions of solutions and strengths. In add-ition, the ideal of ‘strength’ may need to be more contextual than allowedfor in generic models. Yet, complexity in appreciating unique suffering is alsoapparent in some SFT texts. As noted earlier, ‘coping’ questions are a centralpart of SFT developed to use where hope is missing or simple solution-work isnot appropriate:

Like all workers, we encounter clients who are feeling hopeless andseem able to talk only about how horrible their present is and howbleak their future looks. Sometimes these clients are experiencingan acute crisis that gives rise to their hopelessness, and at other timesthe hopelessness represents a persistent pattern of self-expression andrelating to others. In both cases, coping questions can be helpful inuncovering client strengths.

(de Jong and Miller, 1995: 733)


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Feminist concerns

Dermer and colleagues’ (1998) feminist critique of SFT starts from the premisethat such critiques can ‘identify gender and power imbalances and biasesunintentionally perpetuated through therapy’ (p. 240). Drawing on one of deShazer’s publications (1985) and comparing SFT to Leupnitz’s (1988) model offeminist therapy, they conclude that SFT fails in certain respects but in othersis congruent with feminist ideals. Dermer and colleagues’ (1998) principalobjections centre on:

(a) the concentration on behaviour change to the near exclusion ofinsight or explanation: a ‘tendency to overlook larger contexts withinwhich families operate’ (p. 241);

(b) (the) adherence to notions of circularity leading to a rejection of theconcept of blame as ever helpful. Making a distinction between ‘non-productive blame’ and ‘other-angered blame’ (the former obscureseach individual’s responsibility and the latter identifies limitationsplaced on subordinate groups by dominant groups) Dermer et al.assert that both feminism and solution-focused perspectives ‘recog-nize that nonproductive blaming is not therapeutic, and both perspec-tives highlight responsibility . . . [they] agree on matters of personalresponsibility but differ on the subject of blame’ (p. 242);

(c) the relativist tendency inherent in SFT. By placing a great emphasis onclient-determined goals, it can be charged with taking a position ofabsolute relativism leading to unethical practice if no stand is taken tochallenge damaging or dangerous goals. This possibility risks leadingto a lack of attention to pressures inherent in unequal power rela-tions, a consequent failure to engage in any thorough pluralist analy-sis (‘which examines the possibility that what is good for the familymay not be what is good for an individual’ p. 243); and

(d) the ‘neutral’ therapist as advocated in SFT is more likely to unwit-tingly collude with existing oppressions. Dermer et al. (1998) areparticularly critical of the espousal of a neutral stance in domesticviolence, which while condemning the violence itself will make nomove to advocate a woman leaving a violent partner, or to sidewith a woman against a violent partner. Yet Lipchik (1991) defendsthe use of SFT in ‘spouse abuse’, asserting that her priority is alwaysthe prevention of further violence, that therapy stops if the com-mitment to ending violence is breached, and that while she focuseson solutions that are ethical and consistent with clients’ own values,one of her own beliefs is that ‘sociopolitical issues must be addressedin some way in all cases’ (p. 63). The subsequent development ofspecific treatment programmes for spousal abuse (or domestic


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violence as it is more commonly known in the UK and Ireland), suchas that by Milner and Singleton (2008), which adopt a solution-focused approach within a clear ethical framework, indicates thatadvances in the practice model are possible which retain the integrityof the approach as well as incorporating a clearer ethical position.

Where SFT and feminist therapy do converge is on the position of thetherapist and the value base of the approach. The feminist aims to adopt aposition that is enabling and that values purposive self-disclosure as a startingpoint for emphasizing difference, and in this respect is roughly similar tosolution-focused therapists. Solution-focused therapy is seen to be most con-gruent with feminist therapy in relation to the role of the therapist and thenature of the therapeutic relationship. Both advocate a collaborative relation-ship, clear therapeutic goals, and attention to the power of language. Dermeret al. (1998) conclude that while SFT uses methods congruent with feministtherapy, it falls short of feminist principles in its lack of attention to inequalityand gender relations. They are correct in their identification of the lack ofstructural or gendered analyses within the original SFT theory. This weaknesshas been acknowledged from an early stage of SFT’s development by womentherapists such as Lipchik (1991, 2002), Lethem (1994), and Dolan (1991),who have developed their SFT practices to include a more explicit ethicalstance linked to feminist concerns.

The charge of being ‘apolitical’

A key issue in the feminist critique is how overtly or explicitly political thetherapy process should be. For Dermer et al. (1998), as feminist scholars, ther-apy is viewed as a political process, and ‘as such, therapists should preservetheir own beliefs while appreciating other positions’ (p. 243). Neutrality is seenas an unacceptable position because ‘failure to espouse one’s own beliefs andvalues may unintentionally reinforce the status quo. Clients may interpretneutrality as agreement with their political and personal views’ (p. 243). Forde Shazer, on the other hand, it is unacceptable for the therapist to promotetheir own values and beliefs in sessions. He distinguishes between the goals oftherapy and therapists’ personal orientations:

Therapists ask questions and make suggestions that are designed tohelp clients improve their lives . . . Therapists who fail at this job failat therapy, no matter what else they may accomplish in the process. . . Therapists often use [certain] questions and answers to definetherapy as a cause, and to assign different kinds of therapy to differentcauses. Stories about these issues are mostly told by therapists to othertherapists. Thus, clients’ concerns and influence on the therapy


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process are often minimized in these stories. Understandably, mostclients have little interest in them. Why should clients care about theintellectual, political and other causes with which their therapists areidentified? Clients have their own problems.

(Miller and de Shazer, 1998: 367)

Power and influence concerns

The development of more gender-sensitive forms of SFT, such as thosedescribed above, suggest that it is possible to combine the broad concepts ofsolution-focused therapy with anti-oppressive practice and a more explicit eth-ical position as required for helping professions in public services. Yet the caseremains that unless the practitioner comes to SFT with an already developedsensitivity to gender and power issues, he or she will not find a frameworkfor anti-oppressive practice in the original theory. It is only in more recentconceptualizations (Turnell and Lipchik, 1999; Lipchik, 2002; Macdonald,2007) that an explicit acknowledgement of the importance of relationship andcontext has been developed. Lipchik (2002), for example, outlines how sheproposes ‘a theory and basic assumptions for SFT that refutes the frequentaccusation that SFT is formulaic and mechanical. It diverts emphasis fromtechniques to the therapist–client relationship . . . and to the use of emotions’(p. 9). Her concern relates to areas that suffered neglect in the over-emphasison a minimalist approach to therapy; also to the isolation of language ‘fromthe living human systems we are’ (p. xiv). Being reductionist in the descriptionof a practice model is one matter, but tied to this is the lack of an analysis of theuse of power and influence in the practice models we adopt. This is a point thatI consider requires further emphasis and clarification for ethical practice inpublic services and so warrants a separate section in Chapter 3.

Conclusions

The ‘ideological currents’ that accompanied solution-focused therapy’s rise inpopularity include:

1 Growing criticism of family therapy from feminists, clients, and othersfor its lack of attention to gender and power issues, the suggestionof ‘dirty tricks’ in strategic therapy, its lack of user-friendliness toconsumers, and its lack of attention to outcome studies (Howe, 1989;Reimers and Treacher, 1995). Changes were needed if family therapywas to fulfil its potential as an ethical and effective practice.

2 The increasing importance of social constructionism and con-structivism as epistemological influences in the postmodern era.


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Solution-focused therapy is seen to fit the category of social con-structionist models of therapy, and also ‘fits well in the present post-modern environment because of its emphasis on and belief in helpingclients construct solutions that best fit their own lives’ (Mills andSprenkle, 1995: 371). Given the range of criticisms that family ther-apy was attracting at the time, the appeal of SFT is obvious: it oper-ates from principles that emphasize the client as a person ofresources; it questions the assumption that the therapist knows best;and it redefines the role of the therapist as facilitator rather thanexpert.

3 The advent of managed care and budgetary restrictions to psycho-logical therapies. Not only in North America but also in Europe,there is increasing curtailment of treatment lengths that both pub-lic services and insurance companies will cover, mainly due to theneed to curtail ever-escalating health care expenditure. All brieftherapies, not only SFT, stood to gain from this restriction ofchoice, although narrative and solution-focused therapies were seento have an advantage as ‘postmodern approaches of establishedbrevity’ (Mills and Sprenkle, 1995: 375). Debates about resource-ledas opposed to needs-led decision-making and the curtailment oftherapist discretion need to continue, but within a wider context –that therapy in itself is a very lucrative market and one which,some argue, in itself can be disabling and disempowering in itsneglect of natural healing and spontaneous recovery phenomena(Furedi, 2004; Saleebey, 2008). To some extent, the contested claimsand debates about SFT point to a phenomenon known as the ‘polit-ics of theory’. This suggests that ‘proponents of particularapproaches compete to achieve acceptance and status for theirmodel’ (Payne, 1997: 3).

The philosophy of SFT is primarily humanistic with the emphasis on theclient’s experience of the encounter and a strong belief in the potential ofinnate human resilience and resourcefulness. Solution-focused therapy shareswith cognitive-behavioural therapy an emphasis on establishing small goals,use of scaling and self-assessment, the importance placed on the client’s viewof the problem, and recognition of the often-disabling effects of stuck patternsof negative thinking, including hopelessness. Solution-focused questions areproposed as specific tools that can be used to develop the strengths philosophy(Saleebey, 1992, 1997, 2001, 2005, 2008) on a micro-practice level – withindividuals, couples, and families: ‘It is hard to imagine a tighter fit betweenphilosophy and practice than that between the strengths perspective andsolution-focused interviewing questions’ (de Jong and Miller, 1995: 735).

The most significant criticisms of SFT have been:


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• of exaggerated claims for its effectiveness and the relative paucity ofrigorous scientific studies to justify its superiority;

• of its omission of any structural or gender analysis of power relationswithin client systems and client–therapist systems and lack of atten-tion to these in the therapy process;

• concerns about the assumption that brief therapies can resolve alldifficulties;

• the danger of clients in need not being offered longer-term supportsand interventions;

• the ethical problems that can arise if concepts of neutrality and prag-matism are taken too far without sufficient attention being paid toissues of influence and power; and

• the risks associated with a simplistic application of a positive psych-ology, which can in effect concentrate the focus on the individualexperience, blame the client for wider societal ills that cause theirproblems, and imply that a simple cognitive shift can work miracles.

Some of the issues raised by these critiques can be addressed in the form ofquestions regarding practitioners’ use of SFT:

• Do practitioners use it to the exclusion of other theories and models?• Is adoption of the approach wholesale or selective?• Do practitioners use it primarily in a time-limited and performance-

focused way?• Are clients’ narratives ignored?• Do workers try to use it to persuade clients that their troubles do not

exist?

In Chapter 3, following an analysis of the ethical dimensions of practice inthe helping professions in Chapter 2, an attempt is made to address thesequestions drawing on relevant research studies.


Documents

1 Solution-focused therapy: twenty years on · of paradox and the strategic wizardry of Milton Erickson’ (Guerin, 1976: 20). While this is a somewhat dated de ﬁnition, it is the